Effect of temperature maintenance by forced-air warming blankets of different temperatures on changes in inflammatory factors in children undergoing congenital hip dislocation surgery.

BACKGROUND: Hypothermia is associated with many adverse clinical outcomes in pediatric patients, and thus, it is important to find an effective and safe method for preventing peri-operative hypothermia and its associated adverse outcomes in pediatric patients. This study aimed to investigate the effect of forced-air warming blankets with different temperatures on changes in the transforming growth factor-ß (TGF-ß), tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, and IL-10 levels in children undergoing surgical treatment for developmental displacement of the hip (DDH). METHODS: The study included 123 children undergoing surgery for DDH under general anesthesia. The patients were randomly assigned to three groups, using a random number table: the 32, 38, and 43°C groups according to the temperature setting of the forced-air warming blankets. For each patient, body temperature was recorded immediately after anesthesia induction and intubation (T0), at initial incision (T1), at 1 h after incision (T2), at 2 h after incision (T3), at the end of surgery (T4), immediately upon return to the ward after surgery (T5), and then at 12 h (T6), 24 h (T7), 36 h (T8), and 48 h (T9) after the surgery. The serum levels of TGF-ß, TNF-α, IL-1ß, and IL-10 were measured at T0 and T4 for all groups. RESULTS: The number of patients with fever in the 38°C group was significantly less than those in the 32 and 43°C groups (χ = 6.630, P = 0.036). At T0, the body temperatures in the 38 and 43°C groups were significantly higher than that in the 32°C group (F = 17.992, P < 0.001). At T2, the body temperature was significantly higher in the 43°C group than those in the 32 and 38°C groups (F = 12.776, P < 0.001). Moreover, at T4, the serum levels of TGF-ß (F = 3286.548, P < 0.001) and IL-10 (F = 4628.983, P < 0.001) were significantly increased in the 38°C group, and the serum levels of TNF-α (F = 911.415, P < 0.001) and IL-1ß (F = 322.191, P < 0.001) were significantly decreased in the 38°C group, compared with the levels in the 32 and 43°C groups. CONCLUSION: Force-air warming blankets set at 38°C maintained stable body temperature with less adverse outcome and effectively inhibited the inflammatory response in pediatric patients undergoing surgery for DDH. CLINICAL TRIAL REGISTRATION: ChiCTR1800014820; http://www.chictr.org.cn/showproj.aspx?proj=25240.

The Incidence of and Risk Factors for Postoperative Fever after Cleft Repair Surgery in Children.

PURPOSE: The characteristics of postoperative fever after cleft repair surgery in children are unknown. Thus, the purpose of this study was to determine the incidence of and risk factors for postoperative fever. DESIGN AND METHODS: We retrospectively assessed 328 children who underwent cleft surgery at our hospital between March 2016 and April 2017 and were followed up for at least 3 days postoperatively. Fever was defined as a body temperature ≥38.0 °C. RESULTS: Seventy-one percent (n = 233) of patients developed fever within 72 h postoperatively, and most cases of postoperative fever were benign. Patients most frequently developed fever within 24 h postoperatively, and the occurrence of fever significantly decreased between 24 and 72 h postoperatively (p < 0.001). The incidence of fever with temperatures between 38.0 °C and 39.0 °C was higher than that of fever with temperatures ≥39.0 °C (p < 0.001). The mean duration of an episode of fever was 4 h. The type of surgery, method of anesthesia, and duration of anesthesia and surgery were found to be correlated with postoperative fever after cleft surgery. CONCLUSIONS: Most cases of postoperative fever after cleft surgery were benign occurrences. Postoperative fever after cleft repair surgery was characterized by a low grade, an early onset and a short duration in children. The method of anesthesia, duration of surgery and duration of anesthesia were risk factors for postoperative fever. PRACTICE IMPLICATIONS: Our results could help healthcare providers to gain increased knowledge of the risk factors for fever and when and how to treat postoperative fever.

A survey of five first-level hospital ethics committees in Urumqi, China.

This paper presents the results from a survey of first-level hospitals in Urumqi, China. The survey had two parts: the first part was aimed at understanding the operation of the ethics committees of first-level hospitals, including the process for electing members and the variety of members' backgrounds. Information was also gathered about the establishment of criteria, operational rules and regulations, and standard operational procedures. The aim of the second part was to investigate the level of understanding among technicians and doctors about the function of the ethics committees. This paper identifies and analyzes some deficiencies found in the operation of hospital ethics committees, offers some constructive suggestions for improvement, and promotes the role of the Xinjiang Uygur autonomous region hospital ethics committees.

Regioselective synthesis of 1,3,5-substituted benzenes via the InCl(3)/2-iodophenol-catalyzed cyclotrimerization of alkynes.

A novel indium(III)-catalyzed cyclotrimerization of alkynes in the presence of 2-iodophenol gave 1,3,5-substituted benzenes in excellent yields with complete regioselectivity. The reaction condition is tolerant to air, and atom economical, in accordance with the concept of modern green chemistry. This method provides a rapid and efficient access to 1,3,5-substituted benzenes.